Accident and Health Insurance Basics

at what age does an individual qualify for Medicare?

65

A hospital indemnity policy will pay...

A benefit for each day the insured is in a hospital.

Which of the following groups would probably be covered by blanket insurance?

A university's sports team. (A blanket policy covers members of a particular group when they are participating in a particular activity. Such groups include students, campers, passengers on a common carrier, or sports teams. Often in the covered individuals name is not known because individuals come and go. Unlike group health insurance the individuals are automatically covered, and they do not receive a certificate of insurance.)

What is an important feature of a dental expense insurance plan that is not typically found any medical expense insurance plan?

Diagnostic and preventative care. (Dental expense insurance is a form of medical expense health insurance that covers the treatment, care and prevention of dental disease and injury to the insured's teeth. An important feature of a dental insurance plan which is typically not found in a medical expense insurance plan is the inclusion of diagnostic and prevention care (teeth cleaning, fluoride treatments, etc.)

A policy which covers medical costs related to a specific condition is called a...

Dread Disease Policy

which benefits would a disability plan most likely pay?

Income lost by the insured's inability to work.

in franchise insurance, premiums are usually...

Lower than individual policies, but higher than group policies.

underwriting is a major consideration when an insured wishes to replace her current policy for all of the following reasons except:

Premiums always stay the same. (underwriting is important when replacement is involved. It is an underwriters duty to evaluate risk and decide whether or not a person is eligible for coverage. When replacement is involved, the insured may be under the assumption that a replacing policy is in his/her best interest, but after being evaluated by an underwriter, where premium and risk are exchanged, and insured may not be paying the same premium or receiving the same benefits.)

An agent misrepresents the details of an insured's new insurance contract that will be replacing the current contract. What will most likely happen?

Suspension of license. (If an agent engages in misrepresentation during the replacement of a health insurance contract, he/she will be exposed to errors and omissions liability, which would result in either the suspension or revocation of the agents insurance license.)

An insured who has an accidental death and dismemberment policy loses her left arm in an accident. What type of benefit will she most likely receive from this policy?

The capital amount in a lump sum.

What is not required for a producer to tell a prospect?

What requirements the producer needed to meet to obtain the insurance license.

When is the insurability conditional receipt given?

When the premium is paid at the time of application.

In which of the following cases with a credit disability policy be issued?

a. A person receiving disability benefits cannot receive a credit disability policy. b. if an insured has filed bankruptcy and his premiums are waived, he can be issued a credit disability policy. *c. if an individual is in debt to a specific creditor, payments will be made for him/her until the return to work. d. if a person receives disability benefits, he or she is eligible for credits on their group policies for future disabilities.

A typical accidental death and dismemberment policy covers all of the following losses except:

a. Limb. b. Life. *c. Income. d. Eyesight.

which of the following may not be included in an insurance companies advertisement?

a. The policies' limitations or exclusions. b. The name of a specific agent. c. an identification of a limited policy as a limited policy. *d. that it's policies are covered by a state guaranty association.

Which of the following is true regarding limited health insurance policies?

a. They cover all sickness or accidents that are not specifically excluded. b. They are limited to those involved in a group health plan. c. They cover every need of a health insurance policy holder. *d. They only cover specific accidents or diseases.

What document describes an insured's medical history, including diagnosis and treatment?

attending physician statement. (And attending physician statement is the best way for an underwriter to evaluate and insurance medical history. The report includes past diagnosis, treatment, length of recovery time, and prognosis.)

Medicaid is sponsored by what kind of sources?

both state and federal.

A health insurance plan that covers all accidents and sicknesses that are not specifically excluded from the policy is referred to as a...

comprehensive plan.

which of the following coverages is not monitored by the employee retirement income security act (ERISA)?

golden parachutes (ERISA Has a complex series of rules that cover pension, profit sharing stock bonus, and most "welfare benefit plans," such as health and life insurance.)